How to get your medical records, how much you can be charged, and why you need them

Federal and Texas laws give you important rights to have access to your medical records

July 13, 2017

As a medical malpractice lawyer, one of the most common things I hear from my clients is how difficult it is to get a copy of their medical records.

Time and time again I hear how patients feel like they are getting the run-around from hospitals and doctors’ offices. Then, even if they finally get a copy of the medical records, they seem to be missing key pages and information.

At Painter Law Firm, we devote our practice to medical negligence cases and have a legal assistant whose main daily focus is ordering client medical records. To get the job done in a timely manner, we have to know what the law has to say about patient rights to their medical records.

There are federal laws and state laws that apply.

HIPAA: The federal law

HIPAA is an abbreviation for the Health Insurance Portability and Accountability Act of 1996. It is a landmark law that protects the privacy of health care information, but at the same time also gives patients right to that information.

Under HIPAA, health care providers, including hospitals and doctors, have to provide individuals (and others who are authorized by the individual) with access to their medical and billing records, insurance information, lab test results, medical images (things like X-rays, CT scans, MRI scans), clinical case notes, and other similar documents.

The obligation to provide the medical records is triggered by a request. The law does not require the request to be in writing, but doctors and hospitals may require a written request and can even make patients use their own custom form.

You can request paper copies of medical records or electronic copies. If the hospital or doctor maintains electronic medical records, then it must provide the requested records in electronic format, if the records are readily producible electronically. As an alternative, you can also request a summary of the medical records requested.

The doctor or hospital has to provide access to your records in the manner that you request, whether picking them up, or having them mailed, emailed or put on a CD. Although some providers may balk at providing medical records by email, mail and e-mail are generally considered acceptable. Thus, they cannot require you to travel to their office to pick up the records, if you request that they be mailed or emailed.

The HIPAA law encourages hospitals and doctors are to provide medical records as soon as possible, but no longer than 30 calendar days from the date of the request. If they run into a problem, though, they can extend the 30-day deadline once by an additional 30 days, but have to provide you with an explanation and the date when the records will be available.

Health care providers can charge a reasonable, cost-based fee, based on the labor for copying the records, in either electronic or paper format; supplies for creating the copy; postage; and preparation of a summary explanation, if requested. No other fees are allowed.

Texas Health & Safety Code 241.154: The Texas law

Texas law requires a patient or legally authorized representative to provide a written authorization to a hospital or doctor in order to get a copy of medical, billing, or other records, or to arrange for access to review the records.

At first glance, the deadline seems more aggressive than HIPAA, requiring hospitals to respond “as promptly as required under the circumstances,” but within 15 days of the request and payment are received.

The wrinkle is that health care providers may take two weeks or more to even provide a cost estimate or invoice, and the 15-day deadline does not begin ticking until the payment has been made. The one exception is when there is a medical emergency, when access must be granted immediately.

Although they sometimes try this, health care providers cannot deny you a copy of your records because you have not paid for the treatment or services received.

By far, the most economical way to obtain your medical records is by making a request in writing for all copies of medical records in an electronic format. If the doctor or hospital maintains the records electronically and you request them in electronic format, then they have to produce them to you electronically, with a capped fee of $75.00 for processing, plus the cost of shipping.

If you fail to ask for the records in electronic format, get ready for a whopping bill. Hospitals like Houston Methodist Willowbrook Hospital, Kingwood Medical Center, and others use off-site records services to handle records requests.

I recently sent a written request for Houston Methodist Willowbrook Hospital for all of a client’s medical records in electronic format. The hospital’s records service, a company called Ciox, send the records on three CDs along with a bill for over $3,800. I sent them a copy of the Texas statute and asked them to correct the invoice. Insisting that the hospital follow the law will end up saving my client over $3,700 in expenses, once the case is resolved.

Why you need a copy of your medical records

There are lots of reasons why you should get a copy of your medical records. I will highlight three.

First, doctors frequently do not tell you everything in their often-rushed conversations with you. If you regularly obtain copies of their office or hospital records and notes, you will be better informed about your health care and can also ask for explanations of things that you do not fully understand.

Second, they help in continuity of care. If you see a new doctor or specialist, your medical records may have important information that your new treater needs.

Third, there may be errors. I review client medical records every day and frequently see what I call “chart creep.” A doctor or nurse may write something in the medical record that is incorrect and it gets carried forward in the documentation for every future visit. Other times, important information like your medication list may be wrong. Sometimes this can be dangerous, and having a copy of your medical records give you a chance to provide correct information to get your chart updated.

Painter Law Firm handles medical malpractice cases

Knowing the ins and outs of medical records is just one example of why you should contact an experienced medical malpractice attorney if you or someone you care for has been injured because of the mistake of a hospital, doctor, surgeon, nurse, or pharmacy. For a free consultation about your potential medical negligence case, call us at 281-580-8800.

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Robert Painter is a medical malpractice lawyer at Painter Law Firm, in Houston, Texas, where he handles all kinds of medical negligence and wrongful death cases and trials. As a past editor-in-chief of The Houston Lawyer and current member of the editorial board of Texas Bar Journal, attorney Robert Painter frequently writes and speaks about medical malpractice topics to educate other lawyers and the general public.